Over Diagnosed?

ADD & ADHD are on the rise in the US. The question is, “Why?”

By Taylor Smith | Healthy-Mag.com

Many psychologists, researchers, and parents have fought hard over the last 50 years to raise awareness for ADHD as a legitimate psychological disorder. And now, thanks in part to their efforts and the numerous studies the have been performed all over the world, almost all of us agree that ADHD is a very real disorder that affects children and adults alike.

This comes as no surprise these days, but the ADHD issue was not always so clear-cut. Once upon a time, hyperactive and impulsive children, classic symptoms of ADD or ADHD, were labeled as bad seeds. Now, society readily recognizes that most of these children have a real neurological disorder that needs treatment—that much of their behavior is the product of something outside of their control.

According to a recent report from the Centers for Disease Control (CDC),however, the number of children who have been diagnosed with ADHD has soared in the last 20 years, from 600,000 in 1990 to 3.5 million this year. This data, alongside mainstream media articlesand television programs, has people asking, “Why?” The answer, unfortunately, is not especiallyforthcoming orsimple. There are many factors currently at play.

One side of the argument would suggest that increased public awareness, largely a factor of demonstrably augmented publicity and widespread ad campaigns by pharmaceutical companies over the last 20 years, is the main reason. As parents have become more aware of ADHD and its accompanying symptoms, it’s logical to think that more parents have noticed some of these symptoms in a rambunctious child. Doctors are also made to see the world through increasingly “ADHD” colored glasses as pharmaceutical sales people continue to beat down their door, pushing the latest and greatest ADD and ADHD treatments that they claim have little-to-no side effects.

Dr. Aaron Kesselheim of Brigham and Women’s Hospital in Boston, who specializes in pharmaceutical ethics, recently told the NY Times, “There are decades of research into how advertising influences doctors’ prescribing practices.” He went on to say that doctors are more likely to communicate to you what the drug company told them, whether it’s the benefits of the drugs or the risks of those drugs.

There are few who would dispute the legitimacy of ADHD, typically and historically estimated to affect about 5 percent of the population, as a disorder that hinders an individual’s ability to achieve success at school or work. Moreover, medication is often the most effective means of controlling the impulsiveness and inability to concentrate or focus.

We’ve all heard the success stories and patient testimonials from people who have truly benefited from the use of stimulants in treatment for ADHD. There’s no doubt that lives have been benefited by a correct diagnosis and proper treatment, but what about the lively little boy, who might be a real handful, who is improperly diagnosed with ADHD? Increased awareness for any kind of disorder or illness is a knife that cuts both ways.

The other side of the debate may cite statistics like the ones above and say, “As we understand more about the disorder, we’re able to diagnose cases that went undiagnosed in the past.”

Sure, we correctly diagnose more cases of ADHD because we know more about the disorder. But we also have a tendency to chalk up bad behavior to ADHD, insisting that our doctors prescribe medication so that we can get our children under control. Overworked, rushed doctors oblige pushy parents and a young boy is put on stimulants that he doesn’t need toward some unknown end and undeterminable consequence.

Is ADD and ADHD a product of environmental factors, then? Is it hereditary? Or is this increase in the rate of diagnosis and prescriptions merely the effect of confirmation bias? The answer is likely that it’s a combination of all three.

According to CHADD (Children and Adults with Attention-Deficit/Hyperactivity-Disorder) a non-profit organization that promotes education, advocacy and support for individuals with ADHD, “Research has demonstrated that ADHD has a very strong neurobiological basis. Although precise causes have not yet been identified, there is little question that heredity makes the largest contribution to the expression of the disorder in the population.”

Whether we’re facing some unknown factor that’s increasing the rate at which ADHD occurs within our population or whether this rise in diagnoses and prescriptions is nothing more than a serious case of confirmation bias, the fact remains that we face a growing problem. We can’t let ourselves be duped by pharmaceutical companies who stand to profit from our readiness and eagerness to embrace miracle drugs that fix children’s bad behavior and that promise to make them live up to their full potential. Similarly, for our children’s sake, we can’t let increasing diagnoses and media article dissuade us from seeking appropriate medical attention for ourselves or loved ones.